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A130 LONGITUDINAL GROWTH OF PREESCHOOLERS WITH EOSINOPHILIC ESOPHAGITIS

BACKGROUND: Eosinophilic esophagitis (EoE) is an immune-mediated condition involving eosinophils infiltrating the esophagus. While adults predominantly present with dysphagia, infants and preschoolers can present with vomiting, poor solid food progression, and oral aversion. Growth is a concern at d...

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Detalles Bibliográficos
Autores principales: Carrión-Jaramillo, E, Vurzinger, M, Avinashi, V
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8859181/
http://dx.doi.org/10.1093/jcag/gwab049.129
Descripción
Sumario:BACKGROUND: Eosinophilic esophagitis (EoE) is an immune-mediated condition involving eosinophils infiltrating the esophagus. While adults predominantly present with dysphagia, infants and preschoolers can present with vomiting, poor solid food progression, and oral aversion. Growth is a concern at diagnosis as well as in follow-up based on poor intake, prescribed food elimination, and the potential impact of swallowed steroids. AIMS: Assess baseline anthropometric measurements in preescholers with EoE and evaluate their growth parameters in follow up. METHODS: A retrospective chart review of patients with EoE at BC Children’s Hospital from 2007–21. Inclusion criteria were patients diagnosed before 5 years, with > 2 anthropometrics measurements. Variables included weight, height, BMI, and Z-scores (CDC >2 years; WHO <2 years). The change in Z-scores were calculated between the first registered clinical visit after diagnosis and the most recent growth parameters available. Statistical difference between Z-scores for height and BMI was determined with a paired t-test. Differences in growth according to treatment used one way t-test. RESULTS: There were 44 patients included. Mean age of diagnosis was 3 years, 82% were male. The average follow up time was 4.9 years (0.5–12.2 years). At baseline, 1 patient was severely malnourished (Z<-3) and 1 was moderately malnourished based on BMI (Z<-2). At follow-up there were 2 patients with moderate malnutrition. The change in BMI Z-scores over time was relatively neutral -0.05±1.3SD but there were 3 patients with a decline in Z-score more than 2, a different way to represent malnutrition. Stunting was more common at baseline with 3 patients having severe stunting (Z<-3), and 5 having moderate stunting (Z<-2). At follow-up 1 patient had severe stunting BMI (Z<-3), and 1 had moderate stunting (Z<-2). The change in height Z-scores was net +0.41±1.21SD. Last reported treatments included 45.5% on steroids, 18.2% on elimination diet, 11.4% on steroid/diet, 4.5% on PPI, 4.5% on PPI/diet and 15.9% no treatment. There were no significant differences in BMI Z-scores or height Z-scores according to treatment. CONCLUSIONS: Among those diagnosed with EoE at less than 5 years of age, BMI was stable from diagnosis through follow up and reflected the general population. Stunting was observed in as many as 1/5 of patients at diagnosis but did show improvement in follow up. Further analysis would benefit from a larger sample, further treatment details and correlation with esophageal inflammation. FUNDING AGENCIES: None